Uncategorized

Helping Couples Conceive When Infertility Looms – MM1704

Infertility indicates a difficulty in conceiving or carrying a pregnancy to term, but it is not synonymous with sterility (the inability to reproduce). The distinction
matters as over 50% of young adults who experience infertility may eventually conceive. In general, an estimated 84% of couples who have regular sexual
intercourse and do not use contraception will conceive within a year.2 About half of the remaining couples will conceive in the second year, with a cumulative
pregnancy rate of 92% after two years.

Modern Medicine – April 2017

Diagnosing Bacterial Eye Infections – MM1704

Management of patients with bacterial eye disease may involve nothing more
than supportive and palliative therapy; however, in other instances, it may
require aggressive intervention with antimicrobial and anti-inflammatory
agents.

Modern Medicine – April 2017

How Ethical is Paediatric Research? – MM1704

The ethical challenges in paediatric research rest in part on the understanding that physiologically, developmentally, emotionally, and in myriad other ways
children are not merely miniature adults. In an attempt to protect them from potential risks of human research, treatments are often developed for children
by extrapolating results from adult studies, which may actually impose harm. Inclusion of children as research participants requires ethical considerations
over and above those usually applied in the clinic or in the arena of research on adults.

Modern Medicine – April 2017

We welcome you to come and read through our latest, March, edition of Modern Medicine.

This month we focus on; Pulmonology , Diabetes and Cardiology.

We encourage all of our readers to complete the CPD questionnaire for this edition, this can be done on the answer-form included in the magazine, or on our website CPD system.

Modern Medicine, the journal that’s with you wherever you go.

Heart Failure, a Growing Yet Treatable Epidemic – MM1703

The clinical syndrome of heart failure (HF) is a final common pathway of most forms of cardiovascular disease.1 Affected patients typically experience poor
quality of life, recurrent hospitalisations, and premature mortality.2 Although in general the prognosis of patients with HF is considered worse than that for
patients with many cancers, the increasing use of effective selective therapies has led to considerable improvement in the prognosis.

Modern Medicine – March 2017

Acute Coronary Syndromes in Women Different Presentation and Poorer Outcomes – MM1703

The community perception that heart attack is a ‘man’s disease’ contributes to longer delays in women presenting with acute coronary syndrome (ACS).
Heart attacks are common in older women and urgent hospital transfer for management is vital. Presentation of ACS in women can be atypical rather than
typical angina pain. Takotsubo cardiomyopathy is far more common in women than in men. It is brought on by emotional stress and resolves with a favourable
prognosis. Women have a worse prognosis after an ACS. Women respond just as well as men to early reperfusion therapies for coronary occlusion but if there
are delays in diagnosis or treatment delivery, their outcome is worse.

Modern Medicine – March 2017

New Type 2 Diabetes Drugs and Their Cardiovascular Effects – MM1703

Cardiovascular disease is the leading cause of death, morbidity and hospitalisation in people with type 2
diabetes. Several new classes of antidiabetic agents can improve various cardiovascular risk factors, including
weight, blood pressure and lipid profile, in addition to lowering blood glucose levels. Cardiovascular outcome
studies to date support the safety of three dipeptidyl peptidase-4 (DPP-4) inhibitors, one glucagon-like
peptide-1 (GLP-1) receptor agonist and one sodium–glucose cotransporter-2 (SGLT-2) inhibitor in people with
type 2 diabetes. Specific cardiovascular benefits of DPP-4 inhibitors and GLP-1 receptor agonists over standard
diabetes therapy have not yet been demonstrated.

Modern Medicine – March 2017

Smoking and Cardiovascular Disease – MM1703

Smoking cessation is an urgent priority for all smokers, especially those with cardiovascular disease. The cardiovascular risks from
smoking are substantial but are largely reversible by quitting. Quitting is especially important for smokers with pre-existing
cardiovascular disease and GPs are well placed to assist them.

Modern Medicine – March 2017

Diabetic Autonomic Neuropathy An Oft Neglected Entity – MM1703

Diabetic autonomic neuropathy (DAN) is common and important but generally under-recognised. DAN is not
a single entity, but an ‘umbrella term’ with broad clinical implications reflecting the diffuse and integral involvement
of the autonomic nervous system with major body organ systems. Cardiac autonomic neuropathy is a particularly
serious manifestation that may be associated with silent myocardial infarction and represents a major risk for
cardiovascular (CV) mortality. Simple inexpensive tests of cardiac autonomic function are markedly underused.
Gastric autonomic neuropathy is not only associated with upper gastrointestinal symptoms but also has impacts on
postprandial blood glucose control. Erectile dysfunction, another manifestation of autonomic neuropathy, is common
in men with diabetes and a marker of disordered CV function.

Modern Medicine – March 2017

What’s new in Asthma Treatment? – MM1703

Large studies in patients with asthma have revealed different patterns of airway inflammation (asthma phenotypes) that
suggest the possibility of an individualised approach to asthma management. Doctors and patients now have a
wider choice of inhaled corticosteroid (ICS) plus longacting beta agonist (LABA) combinations and inhaler
devices. Evidence suggests that addition of the long-acting muscarinic antagonist tiotropium to ICS plus LABA therapy
may reduce asthma exacerbations while providing modest bronchodilatation. The monoclonal antibodies omalizumab
were recently introduced for the management of patients with severe allergic asthma and severe eosinophilic asthma, respectively.

Modern Medicine – March 2017